The primary purpose of Clinical and Translational Research Services (CTRS) is to facilitate, support, and assure the generation and conduct of high impact patient research in the most efficient and safe way possible to substantially reduce the burden of cancer for the people of Hawai'i and elsewhere. Reducing the disparate burden of cancer experienced by certain minorities and vulnerable populations is a primary goal. In the absence of a university hospital, CTRS has provided the infrastructure to give Hawai'i's community-based providers and the patients they serve access to NCI/NIH-sponsored clinical trials from Minority-based Clinical Oncology Program (MB-CCOP), National Surgical Adjuvant Breast and Bowel Project (NSABP) and research project grants. These trials have provided Hawai'i patients with access to the most promising research opportunities and contribute Hawai'i's unique multi-ethnic population to large multicenter clinical trials. Furthermore, the system maintains cancer care providers at the cutting edge of state-of-the-science care through their participation in the research and the associated continuing education activities of the system. This assures that in most cases patients can access the best care without having to leave the islands and reduces the chance of patients incurring additional costs to travel more than 2500 miles for care, or be separated from their families and social support systems while receiving cancer care. CTRS supports a level of community access and dissemination for clinical and translational research that is seldom seen at other NCI-designated cancer centers. In the absence of a university medical center, all clinical investigation is conducted through community-based providers. This gives unparalleled opportunity to accelerate the progression of discoveries from bench to bedside to community application. With the formation of the Hawai'i Cancer Consortium (HCC) this year, the University of Hawai'i Cancer Center (UHCC) will develop a vibrant clinical and translational research activity of investigator-initiated protocols. CTRS will support the development and conduct of these protocols as a first priority to rapidly translate discoveries of the UHCC's research programs into community-based clinical applications. A large component of CTRS is committed to facilitating the participation of underserved minorities in clinical trials. We have made substantial progress in this respect. Usually more than 200 new subjects each year are enrolled on cancer clinical trials of all phases, with proportional representation of Hawai'i's ethnic minorities. Native Hawaiians and other Pacific Islanders, who represent about 12% of all cancer patients and experience the worst cancer outcome, constitute 25% of patients enrolled.